tbuckley/cabot-search huggingface dataset:
Long-term Hospitalization for Tuberculosis Control
Authors: Linda Singleton
Journal: JAMA (1997)

<h3>Context.</h3> —Patients with tuberculosis (TB) who are nonadherent to therapy or have complicated medical or social problems pose a threat to public health. In some cases, hospitalization may be a necessary component of a comprehensive TB control program. <h3>Objective.</h3> —To describe experience with a new inpatient program for TB control. <h3>Design.</h3> —Retrospective review. <h3>Setting.</h3> —Eighteen-bed, secure, TB treatment unit in a state public health hospital providing a spectrum of acute and chronic care services. <h3>Patients.</h3> —Patients with known or suspected TB who were unable to be treated as outpatients and were hospitalized from 1990 through 1995. <h3>Interventions.</h3> —Volutary or involuntary hospitalization, with medical, psychosocial, and legal services. <h3>Main Outcome Mesasures.</h3> —Admissions, treatment completion, and disposition. <h3>Results.</h3> —A total of 166 patients with a confirmed diagnosis of TB accounted for 214 hospitalizations for TB. The mean age was 42 years, 132 (79.5%) were men, 84 (50.6%) were nonwhite, and 45 (27.1%) were foreign born. At the time of admission, 58 patients (34.5%) were homeless, 116 (69.9%) had a history of abuse of alcohol or other drugs, and 46 (31.7%) were positive for human immunodeficiency virus. The mean length of stay was 119.7days (median, 70days; range, 7-656 days), and was higher among homeless patients than nonhomeless patients (168.8 vs 93.4 days). Of 48 patients (28.9%) who were admitted involuntarily, 21 required long-term confinement under court order. Admission indications (not mutually exclusive) changed over 5 years: nonadherence decreased (95% to 34%), medical complexity increased (14% to 77%), short-term isolation increased (19% to 39%), and involuntary admission decreased (54% to 13%). Of 157 patients with positive cultures for<i>Mycobacterium tuberculosis</i>, 36 (23.1%) were resistant to at least 1 drug, including 16 who were multidrug resistant. A total of 123 patients (74.7%) were discharged to an outpatient setting to complete therapy, 40 (24.1%) required inpatient care to complete therapy, and 3 died (1 from TB) before discharge. <h3>Conclusions.</h3> —A high proportion of patients with TB who failed outpatient therapy completed treatment in a combined medical and psychosocial inpatient unit. During the 5-year study period, involuntary admissions decreased and most patients completed therapy as outpatients. In Massachusetts, this program plays an important role in protecting public health and in providing specialized medical management for patients to complete therapy in a safe and supportive environment.
The Angiotensin AT<sub>2</sub>Receptor: From a Binding Site to a Novel Therapeutic Target
Authors: U. Muscha Steckelings, Robert E. Widdop, Edward D. Sturrock, Lizelle Lubbe, Tahir Hussain, Elena Kaschina, Thomas Unger, Anders Hallberg, Robert M. Carey, Colin Sumners
Journal: Pharmacological Reviews (2022)

<h3>Abstract</h3> Discovered more than 30 years ago, the angiotensin AT<sub>2</sub> receptor (AT<sub>2</sub>R) has evolved from a binding site with unknown function to a firmly established major effector within the protective arm of the renin-angiotensin system (RAS) and a target for new drugs in development. The AT<sub>2</sub>R represents an endogenous protective mechanism that can be manipulated in the majority of preclinical models to alleviate lung, renal, cardiovascular, metabolic, cutaneous, and neural diseases as well as cancer. This article is a comprehensive review summarizing our current knowledge of the AT<sub>2</sub>R, from its discovery to its position within the RAS and its overall functions. This is followed by an in-depth look at the characteristics of the AT<sub>2</sub>R, including its structure, intracellular signaling, homo- and heterodimerization, and expression. AT<sub>2</sub>R-selective ligands, from endogenous peptides to synthetic peptides and nonpeptide molecules that are used as research tools, are discussed. Finally, we summarize the known physiological roles of the AT<sub>2</sub>R and its abundant protective effects in multiple experimental disease models and expound on AT<sub>2</sub>R ligands that are undergoing development for clinical use. The present review highlights the controversial aspects and gaps in our knowledge of this receptor and illuminates future perspectives for AT<sub>2</sub>R research. <h3>Significance Statement</h3> The angiotensin AT<sub>2</sub> receptor (AT<sub>2</sub>R) is now regarded as a fully functional and important component of the renin-angiotensin system, with the potential of exerting protective actions in a variety of diseases. This review provides an in-depth view of the AT<sub>2</sub>R, which has progressed from being an enigma to becoming a therapeutic target.
Military Stays in Bosnia; Vaccinates for Anthrax
Authors: Phil Gunby
Journal: JAMA (1998)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Methods of Correcting Intestine Dysbiosis and Their Influence on the Dynamics of Clinical Manifestations of Hepatic Encephalopathy among Patients with Liver Cirrhosis
Authors: YE.S. SIRCHAK
Journal: GASTROENTEROLOGY (2014)

Here are given the results of a complex survey of 169 patients with liver cirrhosis having signs of liver encephalopathy. We found more significant positive dynamics of clinical manifestations of liver encephalopathy in patients (n = 70), for whom for correcting microbiocenosis of the colon we prescribed in complex therapy not only prebiotics, but also probiotics.
A Practical Treatise on Materia Medica and Therapeutics.
Journal: JAMA (1884)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Safety of combined oral contraceptive pills
Authors: DanielW. Cramer, N.R. Poulter, T.M.M. Farley, C.L. Chang, M.G. Marmot, O. Meirik, JanP. Vandenbroucke, KittyW.M. Bloemenkamp, FransM. Helmerhorst, HarryR. Büller, FritsR. Rosendaal, Hershel Jick, SusanS. Jick, Marian Wald Myers, Catherine Vasilakis, Bruno de Lignieres, G. Plu-Bureau, J. Amiral, L. Guize, P.Y. Scarabin
Journal: The Lancet (1996)
Liposome-mediated PD-L1 multivalent binding promotes the lysosomal degradation of PD-L1 for T cell-mediated antitumor immunity
Authors: Suah Yang, Man Kyu Shim, Sukyung Song, Hanhee Cho, Jiwoong Choi, Seong Ik Jeon, Woo Jun Kim, Wooram Um, Jae Hyung Park, Hong Yeol Yoon, Kwangmeyung Kim
Journal: Biomaterials (2022)
Primary CNS Lymphoma: Progress With Dose-Intensive Consolidation
Authors: James L. Rubenstein
Journal: Journal of Clinical Oncology (2022)

The Oncology Grand Rounds series is designed to place original reports published in the Journal into clinical context. A case presentation is followed by a description of diagnostic and management challenges, a review of the relevant literature, and a summary of the authors' suggested management approaches. The goal of this series is to help readers better understand how to apply the results of key studies, including those published in Journal of Clinical Oncology, to patients seen in their own clinical practice.
Circulating Plasma Cells in Newly Diagnosed Multiple Myeloma: Prognostic and More
Authors: Ioannis V. Kostopoulos, Ioannis Ntanasis-Stathopoulos, Pantelis Rousakis, Evangelos Eleutherakis-Papaiakovou, Chrysanthi Panteli, Panagiotis Malandrakis, Nikolaos Angelis, Nikolaos Kanellias, Nikolaos Orologas-Stavrou, Aristina Papanota, Despina Fotiou, Magdalini Migkou, Maria Gavriatopoulou, Efstathios Kastritis, Ourania Tsitsilonis, Evangelos Terpos, Meletios-Athanasios Dimopoulos
Journal: Journal of Clinical Oncology (2022)
99mTc–Macroaggregated Albumin Liver Lung Shunt Study With Uptake Indicative of Patent Falciform Artery
Authors: Nadia Namous, Daniel Kushner, Simin Dadparvar
Journal: Clinical Nuclear Medicine (2022)

Abstract Intra-arterial injection of radioactive isotope 90-yttrium 90 Y has been used for elective internal radiation therapy for the treatment of localized hepatocellular carcinoma deemed surgically unresectable. It has also been used to treat intrahepatic cholangiocarcinoma and colorectal cancer that has metastasized to the liver. To prepare for 90 Y treatment, preprocedural mapping via hepatic angiography and 99m Tc–macroaggregated albumin liver lung shunt study followed by postprocedural 90 Y SPECT/CT is essential to ensure a targeted therapy. Therapy is contraindicated if lung shunt fraction is greater than 20% for SIR-Spheres. Anatomic variation in hepatic angiography may be present that can lead to complications if unaccounted for.
Palliative care utilization and trends among patients with metastatic breast cancer: A SEER-Medicare analysis.
Authors: Fantine Giap, Young-Rock Hong, Zhigang Xie, Yujia Li, Yi Guo, Julie Ann Bradley, Oluwadamilola Temilade Oladeru
Journal: Journal of Clinical Oncology (2022)

75 Background: Receiving palliative care (PC) is associated with improving quality of life in patients with cancer. Despite its clinical benefits, limited data is available regarding PC utilization among the metastatic breast cancer population. Examining the trends and current patterns of PC provide an opportunity for improved effective implementation of PC in management of patients with breast cancer. Methods: SEER-Medicare linked data was queried to identify patients with metastatic breast cancer aged &gt; 65 years between 2006 and 2017. PC utilization since diagnosis was identified using ICD-9 code V66.7 or ICD-10 Z51.5. Descriptive statistics were used to summarize patient characteristics by the receipt of PC. Multivariable logistic regression was estimated to identify predictors of PC use. Trends in PC utilization were then compared by patient race/ethnicity, residential region, and census poverty rate. Results: Of 11,245 patients with metastatic breast cancer diagnosed between 2006 and 2017 (median survival, 17.9 months), 1,756 (15.6%) received PC (median time from diagnosis to PC, 18.5 months). During the study period, PC use increased significantly from 2.5% in 2006-2007 to 28.1% in 2016-2017 (P trend &lt;.001). Patients with metastatic breast cancer who received PC were more likely to be younger (20.6% among 65-69 years old vs. 11.9% among 80+), living in the West census region (17.2% vs. 14.1% in South), urban areas (16.8% vs. 8.2% in rural), and low poverty rate (16.1% with &lt; 5% poverty level vs. 12.9% with &gt; 20%) (P all &lt;.05). There was no significant difference observed by race or ethnicity (P &gt;.05). Conclusions: There was a significant increase in PC utilization among patients with metastatic breast cancer aged &gt; 65 years between 2006 and 2017. However, its utilization rate remains suboptimal, with geographic, age and income disparities in PC use.
Creating a proactive interdisciplinary approach to care: Embedding oncology care coordination within an oncology patient and family support program.
Authors: Sarah Low, Ayaka Nakaji, Scott A Irwin, Jan-Kees Van der Gaag
Journal: Journal of Clinical Oncology (2022)

51 Background: The benefits of providing psycho-oncology services have been well documented in producing better effective team collaboration, patient outcomes, and reduced healthcare utilization. Cedars-Sinai Cancer spans five locations and serves over 11,000 patients a year. Their robust Patient and Family Support program (PFSP) includes psychiatry, palliative medicine, social work, nutrition, cancer rehabilitation, survivorship, and chaplaincy to envelop patients in multiple dimensions of support. A new oncology care coordination (CC) model embedded a social work (SW) and nurse (RN) CC within PFSP to identify and meet diverse unmet needs of patients through close interdisciplinary collaboration. Methods: Oncology CC was established within PFSP, containing an oncology SW CC and an oncology RN CC. Patients with higher acuity needs were identified through multiple avenues such as: health plan reporting and dashboards in the electronic medical record (EMR) providing alerts for patients with unmet needs. Preliminary data was captured on interdisciplinary collaboration and care coordination from a daily log kept by coordinators, as well as from the EMR. Results: Over 6 months (9/2021 to 2/2022), the PFSP CC team served 688 patients providing 1280 interventions. Of the 1280 interventions, 22% were coordination with other PFSP services; of which 54% was with SCM, 36% with Clinical SW, and 18% represented new referrals. 13% focused on outside services including medical devices, home health, and community resources. 6% comprised of post-discharge calls by the RN CC and 16% represented direct SW CC outreach. Care coordination such as appointment scheduling, assistance with prescriptions and communication with medical teams represented 9%, 1% and 11% of the interventions respectively. Conclusions: Results demonstrated for this subset of patients that the highest needs of oncology PFSP CC were SW and SCM, to address needs such as pain and symptom management, goals of care conversations and community resource linkage. Anecdotally, communication with primary oncology and other medical teams proved to be an essential role of the CC team, particularly to address inpatient to outpatient transitions of care. Discussion: CC team involvement is time-limited and appears to rely on the long-term relationship patients have with PFSP interdisciplinary team members for interventions to be long-lasting and effective. The CC team leveraged existing relationships that PFSP providers had established with primary oncology teams, allowing for timely care coordination. Future goals include: 1) developing an algorithm to better identify patients with higher acuity and unmet needs; 2) measuring impacts of CC services on care outcomes, health care utilization and reduced symptom burden; 3) expanding the CC team to serve more of the patient population.
Racial/ethnic disparities in patient care experiences among prostate cancer survivors: A SEER-CAHPS study.
Authors: Ambrish Pandit, Chenghui Li
Journal: Journal of Clinical Oncology (2022)

291 Background: To evaluate racial/ethnic disparities in patient care experiences (PCEs) among prostate cancer (PCa) survivors. Methods: This retrospective study used 2007-2015 National Cancer Institute Surveillance, Epidemiology and End Results registry data linked to Consumer Assessment of Healthcare Providers and Systems surveys. First survey ≥6 months post-PCa diagnosis was analyzed. We performed linear regression modelling to evaluate the association of race/ethnicity (non-Hispanic White (NHW), non-Hispanic Black (NHB), Hispanic, non-Hispanic Asian (NHA), and other races) with PCE composite measures (getting needed care, doctor communication, getting care quickly, getting needed prescription drugs, customer service), and rating measures (primary physician, specialist, health plan, and overall care) adjusting for demographic and clinical covariates. Results: Among 7453 PCa survivors, NHAs (vs. NHWs) reported disparities in more PCE measures than any other racial/ethnic minority; reported lower scores for customer (ß = -7.58; p = 0.003), getting needed prescription drugs (ß = -3.08; p = 0.020) and specialist rating (ß = -2.32; p = 0.021) besides lower scores for getting care quickly. NHBs scored better on doctor communication (ß = 1.96; p = 0.006) and primary physician rating (ß = 1.28; p = 0.047) than NHWs. No statistically significant differences were found between other races and NHWs. Conclusions: Racial/ethnic minority PCa survivors reported worse experiences than NHW survivors on several PCE measures. Further research is needed to understand reasons behind these disparities and their influence on healthcare utilization and health outcomes among PCa survivors.
Association of area-level mortgage discrimination and guideline-concordant non–small cell lung cancer care in the United States.
Authors: Qinjin Fan, S. M. Qasim Hussaini, Craig Evan Pollack, K. Robin Robin Yabroff, Leticia M Nogueira
Journal: Journal of Clinical Oncology (2022)

3 Background: Disparities in receipt of care for non-small cell lung cancer (NSCLC) are well described. Discriminatory mortgage lending, which limits access to home ownership in specific neighborhoods overall and disproportionately for racialized groups, is a marker of systemic racism and lower levels of neighborhood investment. This may, in turn, decrease access to high quality care. We used the mortgage denial rate as a measure of housing discrimination and investigated its association with guideline-concordant NSCLC care. Methods: Mortgage denial rates were estimated at the zip code tabulation areas (ZCTAs) level using the Home Mortgage Disclosure Act (HMDA) database (2014-2019). Mortgage denial rates represent the proportion of denied home loans to total loans and were categorized into quartiles. Individuals ≥ 18 years diagnosed with NSCLC 2014-2019 were identified from the National Cancer Database and combined with HMDA. Multivariable logistic regression models examined associations between mortgage discrimination and receipt of guideline-concordant care, including surgery, chemotherapy, and chemoradiation. A multivariable Cox proportional hazard model examined the association between mortgage discrimination and time to chemotherapy initiation. Results: Cohort included 450,614 patients newly diagnosed with NSCLC resided in 33,120 ZCTAs. Individuals residing in ZCTAs with higher mortgage denial rates were more likely to be aged 45-64 years, male, non-Hispanic White, with private health insurance coverage and income &lt; $40,000/year. 69% of all patients received guideline-concordant care. Likelihood of guideline-concordant care was lower in neighborhoods with higher mortgage denial rates, adjusting for age and sex (Table). This disparity was present in all care subgroups. Time to chemotherapy initiation was longer for patients in neighborhoods with higher mortgage denial rates. Conclusions: Mortgage discrimination is adversely associated with receipt of guideline-concordant NSCLC care. Our examination of institutional practices leading to barriers in access to resources highlights the critical need to understand the pathways through which area-level mortgage denials impact receipt of equitable cancer care.[Table: see text]
Estimating prevalence and financial impact of “bagging” oncology drugs: Evidence from privately-insured patients with cancer.
Authors: Ya-Chen Tina Shih, Ying Xu
Journal: Journal of Clinical Oncology (2022)

25 Background: “Bagging” is a drug delivery model that distributes physician-administered drugs through pharmacies, most specialty pharmacies. Under the traditional buy-in-bill model oncology drugs are covered in medical benefit, whereas drugs distributed through bagging practices are reimbursed under pharmacy benefit. Several professional associations have urged policymakers to limit or prohibit bagging practices, citing patient safety as the main concern. This study estimated the prevalence of bagging practice and the associated financial impact among cancer patients with private insurance. Methods: We selected 10 cancer drugs with highest total spending from the 2020 Medicare Part B Drug Spending Dashboard. Using 2019-2020 MarketScan data, we identified these drugs from medical and/or pharmacy claims and estimated the prevalence of “bagging” practice as the proportion of patients who had their cancer drugs covered by pharmacy benefit. We compared the per patient per month (PPPM) insurance payment and out-of-pocket expense (OOPE) between medical and pharmacy claims and tested the difference in PPPM costs using non-parametric Wilcoxon test. Results: The top 10 drugs selected for this study included four immunotherapy (pembrolizumab, nivolumab, durvalumab, atezolizumab), five targeted therapy drugs (rituximab, bevacizumab, daratumumab, trastuzumab, pemetrexed), and one supportive care product (pegfilgrastim). The study cohort consisted of 39,757 cancer patients, including 10,599, 19,276, and 17,882 patients (not mutually exclusive) receiving immunotherapy, targeted therapy agents, and supportive care drug, respectively. On average, “bagging” practice was observed in 4.4% of patients, ranging from less than 1% for immunotherapy and 2.4% for targeted therapy to 6.9% for supportive care drugs. The prevalence of bagging practice was higher in comprehensive plans (11.3%) and PPO (4.3%) versus other insurance plan types (3.8%). By census region, the prevalence was highest in Northeast (7.2%) and lowest in North Central (3.4%). Insurance payment PPPM was lower for drugs distributed through bagging practices than the conventional buy-and-bill model (mean $11,075 vs. $13,622; median $9,275 vs. $10,728, P &lt; 0.001). OOPE PPPM exhibited the opposite pattern, with mean and median OPPE $437 and $53 for bagging practices and $186 and $0 for buy-and-bill. Conclusions: We observed wide variation in bagging practices by drug classes, plan types, and geographic regions. Evidence from the privately insured suggested that although bagging oncology drugs appeared to have reduce oncology drug costs for payors, this practice was associated with higher OOP for cancer patients with private insurance. Future research should examine the impact of bagging practices on clinical outcomes, such as treatment delays or disruptions and treatment-related side effects.